Optimizing an Evidence-Based, Disseminable, Free Internet-Based Parenting Program
1 other identifier
interventional
859
1 country
1
Brief Summary
The CDC's Essentials for Parenting Toddlers and Preschoolers program (EFP) is a free Internet resource with the potential to break down barriers to population-wide access to scientifically-based parenting interventions. EFP has considerable promise, but parental engagement, a major issue in the success of universal parenting interventions, remains a challenge. The objective of the proposed research is to optimize EFP by identifying engagement-focused intervention elements to add to EFP that enhance its effects on parenting skills.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Sep 2023
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 19, 2022
CompletedFirst Posted
Study publicly available on registry
January 19, 2023
CompletedStudy Start
First participant enrolled
September 16, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 26, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
August 26, 2024
CompletedJuly 31, 2025
June 1, 2024
12 months
December 19, 2022
July 30, 2025
Conditions
Outcome Measures
Primary Outcomes (4)
Parent Behavior Inventory, item average of Supportive/Engaged subscale
Parental warmth (e.g., physical affection) will be measured by parent completing the 10-item self-report Supportive Engaged subscale of the Parent Behavior Inventory.
6 months
Parent-Child Conflict Tactics Scale, item average of Corporal Punishment subscale
Corporal punishment (noninjurious physical discipline, e.g., spanking) will be measured by parent completing the 6-item self-report corporal punishment subscale of the Parent-Child Conflict Tactics Scale
6 months
Parenting Scale, item average of Overreactivity subscale
Parents' use of harsh or otherwise overreactive discipline (i.e., angry discipline) will be measured by parent completing the 10-item self-report Overreactivity subscale of the Parenting Scale.
6 months
Parenting Scale, item average of Laxness subscale
Use of permissive or lax discipline (e.g., failure to enforce rules) will be measured by parent completing the 11-item self-report Laxness subscale of the Parenting Scale
6 months
Study Arms (16)
Motivational Enhancements + Simplification + Gamification + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core Essentials for Parenting (EFP) intervention and all additional engagement-focused intervention elements: motivational enhancements, simplification, gamification, and low engagement nudges.
Motivational Enhancements + Simplification + Gamification
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement, simplification, and gamification intervention elements.
Motivational Enhancements + Simplification + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement, simplification, and low engagement nudges as intervention elements.
Motivational Enhancements + Simplification
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement and simplification as intervention elements.
Motivational Enhancements + Gamification + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement, gamification, and low engagement nudge as intervention elements.
Motivational Enhancements + Gamification
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement and gamification as intervention elements.
Motivational Enhancements + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement and low engagement nudge as intervention elements.
Motivational Enhancements
EXPERIMENTALParticipants will receive the Core EFP intervention and motivational enhancement as an additional intervention element.
Simplification + Gamification + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and simplification, gamification, and low engagement nudge as additional intervention elements.
Simplification + Gamification
EXPERIMENTALParticipants will receive the Core EFP intervention and simplification and gamification as additional intervention elements.
Simplification + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and simplification and low engagement nudge as intervention elements.
Simplification
EXPERIMENTALParticipants will receive the Core EFP intervention and simplification as an additional intervention element.
Gamification + Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and gamification and low engagement nudge as additional intervention elements.
Gamification
EXPERIMENTALParticipants will view the Core EFP and will be exposed only to gamification as an additional intervention element.
Low Engagement Nudge
EXPERIMENTALParticipants will receive the Core EFP intervention and low engagement nudge as an additional intervention element.
EFP Only
EXPERIMENTALParticipants will receive the Core EFP intervention and not be exposed to any additional intervention elements.
Interventions
Motivational Enhancements (ME) will include three features: 1. Personalized change plan. Parents will describe their intervention goals, motivation for participation, steps they are willing to take to meet those goals, as well as potential barriers to engagement and strategies to try to overcome such barriers. We will display the change plan to remind parents of their personalized responses. ME will also integrate participants' change plan responses into intervention content. 2. Assessment feedback. We will provide norm-referenced feedback for each selected parenting measure after the week 1 assessment. For simplicity, feedback will graphically categorize the parent or child in 3 categories per outcome: red (≥90th %ile), yellow (70-89th %ile), and green (\<70th %ile). 3. Modified, personalized SMS text nudges. Parents will receive 2 weekly personalized SMS messages based on their change plan responses.
We will follow recommendations of research on improving the readability of patient-directed text (e.g., fewer, shorter, less complex words, minimizing colons, semicolons, and decimal points). We will employ the Dale-Chall Readability (DCRI) score, which was developed for health education materials and, compared to other readability metrics, has higher correlations with comprehension. The target DCR score is 7 (8th grade reading level). We will avoid lower DCR scores because moderate levels of complexity enhance, attention, absorption, satisfaction, and ultimately engagement.
Gamification will include four features: 1. Game-like graphical environment (e.g., avatars to represent the participant). 2. Digital rewards. Parents will receive points and badges for completing intervention activities. 3. Leaderboard. A leaderboard will be used to activate competitive motives and social referencing. The leaderboard will display the points/badges of the participant relative to 4 other actual or simulated anonymized parents who are at a similar point in the intervention; their number of points and badges will be determined by those of the participant. 4. Modified, personalized SMS text nudges. SMS text nudges will alternate between Core content (e.g., reminder to complete a module) and reminders about game features such as badges and standings.
SMS text nudges will be sent to participants who have fallen behind in completing specific intervention tasks within a given time window; e.g., failing to log-in to the next module by a predetermined date, timed to program enrollment or in a prespecified number of days since completing the previous module.
All parents will receive the Core intervention content, including text, demonstrations (videos and vignettes), and interactive activities (e.g., skill-building), and comprising five modules: Communicating with Your Child; (2) Giving Directions; (3) Creating Structure; (4) Using Discipline and Consequences; and (5) Using Time-out. The Core intervention will be augmented with more prescriptive behavioral skills practice exercises and SMS text nudges to remind participants to complete intervention modules. All conditions will be housed on Westat servers accessible through any device that can use the Internet, including computers, tablets, and smartphones. Westat has extensive technical capacities for web programming/hosting.
Eligibility Criteria
You may qualify if:
- to 36-month-old child
- ≥18-year-old parent
- Internet access
- willingness to commit to intervention/assessment procedures
- proficiency in speaking and reading English
You may not qualify if:
- child older than 36 months
- parent younger than 18 years
- no access to internet
- not willing to commit to intervention/assessment procedures OR
- not proficient with speaking and reading English
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- New York Universitylead
- Westatcollaborator
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)collaborator
Study Sites (1)
Westat, Inc.
Rockville, Maryland, 20850, United States
Study Officials
- PRINCIPAL INVESTIGATOR
Kimberly Rhoades, Ph.D.
New York University
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- PREVENTION
- Intervention Model
- FACTORIAL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
December 19, 2022
First Posted
January 19, 2023
Study Start
September 16, 2023
Primary Completion
August 26, 2024
Study Completion
August 26, 2024
Last Updated
July 31, 2025
Record last verified: 2024-06
Data Sharing
- IPD Sharing
- Will not share
There is not a plan to make IPD available.